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《The Journal of Traditional Chinese Orthopedics and Traumatology》 2017-01
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Clinical observation on Wuwei Xiaodu Yin(五味消毒饮) combined with Danggui Buxue Tang(当归补血汤) and antibiotics in preventing postoperative infection in patients with limb fractures

HUANG Xiaotao;FANG Lue;XIE Changfa;ZHANG Chi;Cixi Hospital of Traditional Chinese Medicine;  
Objective: To explore the clinical curative effects of Wuwei Xiaodu Yin( 五味消毒饮,WWXDY) combined with Danggui Buxue Tang( 当归补血汤,DGBXT) and antibiotics in preventing postoperative infection in patients with limb fractures. Methods: Eighty patients with fractures in limbs were recruited from Octomber 2014 to March 2016. Forty patients belonged to open fractures and the factures located in upper limbs for 20 patients and lower limbs for 20 patients. Forty patients belonged to closed fractures and the factures located in upper limbs for 20 patients and lower limbs for 20 patients. All patients were treated with surgery and conventional antibiotics,meanwhile,the patients were treated with oral application of WWXDY and DGBXT from the 1st day after surgery,one dose a day for consecutive 5days. The blood was drawn from the median cubital vein or basilic vein before the surgery and at 1 and 5 days after the surgery respectively.The number white blood cells,neutrophil granulocyte ratio,erythrocyte sedimentation rate( ESR),C- reactive protein( CRP) in the venous blood and the serum contents of tumor necrosis factor- α( TNF- α),interleukin- 1( IL- 1) and IL- 6 were measured. Meanwhile,the patients were followed up for observing incision healing. Results: There was statistical difference in the number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 between different timepoints before and after the surgery for patients with open upper limb fractures( F = 8. 245,P = 0. 001; F = 15. 783,P = 0. 000; F = 20. 205,P = 0. 000; F = 16. 033,P = 0. 000;F = 67. 183,P = 0. 000; F = 170. 230,P = 0. 000; F = 142. 375,P = 0. 000). The number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 were higher at postoperative day 1 compared to pre- surgery and postoperative day 5( P = 0. 041,P = 0. 034,P = 0. 025,P = 0. 013,P = 0. 000,P = 0. 000,P = 0. 000; P = 0. 000,P = 0. 002,P = 0. 048,P = 0. 001,P =0. 000,P = 0. 000,P = 0. 000). There was statistical difference in the number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 between different timepoints before and after the surgery for patients with open lower limb fractures( F = 4. 509,P = 0. 017; F = 15. 395,P = 0. 000; F = 27. 359,P = 0. 000; F = 21. 646,P = 0. 000; F = 82. 889,P = 0. 000; F =32. 989,P = 0. 000; F = 129. 262,P = 0. 000). The number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 were higher at postoperative day 1 compared to pre- surgery and postoperative day 5( P = 0. 000,P = 0. 008,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000; P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 001,P = 0. 000,P = 0. 000,P =0. 000). There was statistical difference in the number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 between different timepoints before and after the surgery for patients with closed upper limb fractures( F =14. 733,P = 0. 000; F = 16. 875,P = 0. 000; F = 16. 358,P = 0. 000; F = 13. 280,P = 0. 000; F = 53. 733,P = 0. 000; F = 25. 037,P =0. 000; F = 145. 598,P = 0. 000). The number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 were higher at postoperative day 1 compared to pre- surgery and postoperative day 5( P = 0. 013,P = 0. 004,P = 0. 030,P = 0. 049,P = 0. 000,P = 0. 000,P = 0. 000; P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 008,P = 0. 000,P = 0. 000,P = 0. 000). There was statistical difference in the number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 between different timepoints before and after the surgery for patients with closed lower limb fractures( F = 49. 447,P = 0. 000; F =16. 576,P = 0. 000; F = 30. 166,P = 0. 000; F = 30. 022,P = 0. 000; F = 38. 500,P = 0. 000; F = 32. 951,P = 0. 000; F = 44. 530,P =0. 000). The number of white blood cells,neutrophil granulocyte ratio,ESR,CRP and serum contents of TNF- α,IL- 1 and IL- 6 were higher at postoperative day 1 compared to pre- surgery and postoperative day 5( P = 0. 000,P = 0. 000,P = 0. 003,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000; P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000,P = 0. 000). No infections were found in all patients after surgery and all incisions healed well. The incision healing times for patients with open upper limb fractures,open lower limb fractures,closed upper limb fractures and closed lower limb fractures were 13. 60 + /- 2. 80,14. 10 + /- 1. 29,11. 80 + /- 1. 51 and 13. 60 + /-1. 10 days respectively. Conclusion: The application of WWXDY combined with DGBXT and antibiotic can obviously improve blood inflammatory indexes and prevent postoperative infection in patients with limb fractures.
【Fund】: 浙江省中医药科技计划项目(2014ZB108)
【CateGory Index】: R687.3
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